Aged care providers warn Support at Home is failing to deliver

Support at Home is failing to deliver on its promise of rights-based aged care, according to providers, advocates, carers and consumer groups who told a Senate inquiry that care is effectively being rationed through long wait times, inadequate funding and a system that many older people struggle to navigate.

Over the course of public hearings, witnesses repeatedly highlighted the gap between the program’s stated objective of helping older Australians live safely and independently at home and what they described as the reality on the ground.

At the centre of many concerns was the growing waiting list for care.

Ageing Australia chief Tom Symondson told the inquiry there are more than 100,000 people waiting for a package, around 100,000 people waiting for an assessment, and more than 50,000 people receiving only 60 per cent of the value of their approved package.

“We all know that Support at Home was supposed to carry a simple promise, which is that people would get the care that they needed when and where they needed it,” Mr Symondson said.

“With over 100,000 people waiting for a package, another 100,000 waiting just to be assessed and more than 53,000 receiving only 60 per cent of the value of the approved package when they finally do get it, I do not think we can safely say yet, that people are getting access to care when, and where, they need it.”

Consumer and advocacy groups argued the consequences extend well beyond waiting lists.

Uniting NSW.ACT director of seniors services Saviour Buhagiar told senators that many older people who are assessed as requiring support are unable to actually access it.

“Rights that exist in legislation but not in practice are not rights at all,” he said.

UnitingCare Australia warned that while they are waiting for services, people are deteriorating, entering hospitals and moving into residential care prematurely.

“We know that people are waiting too long for care,” head of government relations Trish Hepworth said.

“In worst cases, we have, sadly, seen across our network several instances of people passing away before they receive their packages.”

“The support isn’t there”

The inquiry also heard repeated criticism of the way funding is allocated.

Former National Disability Insurance Agency chief economist and Hall & Prior director Dr David Cullen argued the current means testing arrangements actively undermine the objective of helping people remain at home.

“The Support at Home means test is economically illiterate,” Dr Cullen told the committee.

“The result of the current means test is that it will force more people, the exact people you want to keep out of residential care, into residential care because you're asking them to pay far too much.”

This issue was echoed by other advocates, who argued the co-payment system was creating barriers for pensioners and low-income older Australians.

COTA NSW chief Gohar Yazdabadi told the inquiry that fears about affordability were changing decisions about whether people seek care at all.

“We’re seeing a significant rise in elder abuse as a direct result of these out-of-pocket expenses for older people,” she said.

“We have people on pensions in private rentals who are paying co-payments. That makes no sense to me.”

MND patients “getting faster access to inadequate funding”

Some of the strongest criticism came from MND Australia, which argued the program is failing people with high and complex needs.

Organisation chief Clare Sullivan said the recent decision to prioritise people with motor neurone disease for assessments was welcome, but ultimately did not address the level of support available.

“Getting faster access to inadequate funding doesn’t solve the problem,” she said.

Ms Sullivan told the inquiry the maximum Support at Home package provided around $78,000 a year, while care costs for some people with advanced MND could reach $400,000 annually. She also questioned the performance of the Integrated Assessment Tool (IAT), which is used to determine package levels.

“The Integrated Assessment Tool is not working for people with MND,” she said.

“Our analysis shows no correlation between the packages they're allocated and their disease progression, their circumstance, their care needs.”

Carers filling the gaps

The inquiry also heard that unpaid carers are increasingly being relied upon to fill service gaps.

Carers Australia chief Joanna Cave told the senators that a dedicated survey found 85 per cent of unpaid carers reported an increased caring workload since the introduction of Support at Home, while almost 50 per cent reported a decline in their wellbeing.

“Support at Home is full of gaps – gaps while people wait to be assessed, gaps while people wait to receive their packages, gaps because their packages don't provide sufficient support,” Ms Cave said.

“Unpaid carers fill those gaps, but there is a human limit to how many of those gaps carers can fill.”

Carers Australia argued that carers remain largely invisible within the system despite being central to its success.

“Our central message to you today is simple: Support at Home cannot succeed unless it also recognises and supports the unpaid carer.”

Government defends reforms

Department of Health, Disability and Ageing officials acknowledged ongoing challenges but pointed to improvements in waiting times and increased package allocations.

Officials told the inquiry that median wait times had fallen to 297 days by June 2026 and reiterated the government’s goal of reducing average waits for support to three months by November 2027.

However, witnesses repeatedly returned to the same theme: while the principles underpinning Support at Home were broadly supported, many believed the system was still rationing care rather than guaranteeing it.

As Mr Buhagiar told senators, the challenge is no longer whether older Australians have rights on paper, but whether they can actually access the care those rights are supposed to guarantee.